In response to the interesting comments made by Dr Boyle, we would like to make the following comments.
The lower complication rate of radiofrequency ablation compared with cryotherapy is not so clearly demonstrated as is argued by Dr Boyle. Although it is true that Pearson et al1 have reported a lower complication rate with radiofrequency, this concerned only pleural effusion and intrahepatic abscess, the latter complication reported in fewer than 2% of patients in a collective review of the world literature2 and surprisingly reported by Pearson et al in 18.5% of cases. The study was nonrandomized, included a quite heterogeneous population of patients, and used an open laparotomy in contrast to the exclusively percutaneous approach used in our study.
Adam R. Percutaneous Ablation of Liver Tumors—Reply. Arch Surg. 2003;138(7):809–810. doi:10.1001/archsurg.138.7.809-a
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